Preoperative serum tumor-associated antigen levels in women with pelvic masses

Article Abstract:

Although early, aggressive surgical treatment and diagnosis can reduce the high mortality associated with ovarian cancer, most patients are initially seen at facilities where such surgery cannot be performed. Therefore, a reliable, noninvasive test to diagnose this condition is highly desirable. One substance that has been measured in blood is CA 125, a tumor-associated antigen (protein) known to be associated with ovarian cancer. However, CA 125 can also be detected in patients with other types of malignancies, benign disease or even on occasion in healthy women. Other antigens, TAG 72 and CA 15-3, are associated with cancer of the ovary and other organs, and it is possible that an assay for all three substances might improve accuracy of preoperative testing. To determine whether blood levels of these antigens could accurately distinguish women with malignant pelvic masses from those with benign conditions, 100 women with pelvic masses who underwent diagnostic laparotomy (surgical inspection of the abdomen) were studied. Forty women were diagnosed with ovarian cancer and three more were given probable diagnoses of this disease. Twelve patients had malignancies of other organs than the ovary, including the endometrium (uterine lining), colon and rectum, and pancreas. Several benign pelvic masses were also diagnosed. The sensitivity of CA 125 in detecting malignant masses was 88 percent, with a specificity (ability to distinguish between ovarian cancer and other conditions) of 83 percent. Use of TAG 72 or CA 15-3 assays increased the specificity of the test, especially for older women. When the three assays were used together, specificity increased to 98 percent for the whole group, and reached 100 percent for older women. In summary, it appeared that measurement of all three antigens could reduce considerably the frequency of incorrect diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Ovarian cancer, Tumor antigens

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A controlled trial of two low-dose heparin regimens for the prevention of postoperative deep vein thrombosis

Article Abstract:

Pulmonary embolism (obstruction of the pulmonary artery, the vessel that carries blood from the heart to the lungs, by a blood clot) is one of the most common major complications in women after gynecologic surgery, particularly when treating malignancy. Since this potentially fatal complication arises as a result of detached clots in the deep veins (deep vein thrombosis), which then travel to the pulmonary artery, prevention of thrombosis is an important goal of postsurgical care. However, the administration of low doses of heparin (an anticoagulant drug) does not benefit all patients. To improve the results of heparin therapy, a study was performed regarding venous embolism in 304 women, who underwent extensive pelvic surgery, mostly for cancer. Patients were randomly assigned to receive one dose of heparin two hours before surgery, then every eight hours for seven days (regimen I); heparin every eight hours before surgery for several doses, then every eight hours afterwards for seven days (regimen II); or no drug treatment (controls). The rationale behind regimen II was that the drug might be ''loaded'' onto the lining of the deep veins, where clots are formed, exerting an enhanced protective effect. The results revealed that thromboemboli (detached clots) occurred in 19 control patients, in 10 from regimen I, and 6 from regimen II. No fatal pulmonary emboli developed in these patients. Regimens I and II were equally effective in preventing clot formation. A discussion is provided of the ways low-dose heparin might work. It is recommended that patients undergoing radical gynecologic surgery be given several doses of heparin preoperatively, then every eight hours postoperatively, according to the protocol of regimen II. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Complications and side effects, Pulmonary embolism, Dosage and administration, Thrombosis, Deep vein, Deep vein thrombosis, Heparin, Gynecology, Operative, Gynecological surgery

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Endometrial cancer: histologic correlates of immunohistochemical localization of progesterone receptor and estrogen receptor

Article Abstract:

In a study of endometrial adenocarcinoma (a cancer of the uterus), antibodies were used to identify the locations of receptors for the female sex hormones progesterone and estrogen. Receptors are components of cells which combine with hormones to alter the function of the cell. Both anti-progesterone receptor and anti-estrogen receptor antibodies (which inhibit the normal action of progesterone and estrogen) were found in the nuclei of large, so-called target cells. Progesterone receptor and estrogen receptor cells were found in the muscle and supportive tissue of the uterus. These regions were distinct from the cancerous areas. This immunohistochemical test for the two hormone receptors can differentiate receptors in muscle and supportive tissues from cancerous elements. It was concluded that this test can provide valuable information in conjunction with results from conventional tests for identifying uterine cancer cells.

Care and treatment, Testing, Physiological aspects, Hormone receptors, Endometrial cancer, Estrogen, Monoclonal antibodies, Progesterone, Adenocarcinoma, Estrogen receptors, Progesterone receptors

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